Pmg South Diabetes Education

LBN: Providence Health & Services - Oregon
Pmg South Diabetes Education is an health care organization with primary practice located at 1698 E Mcandrews Rd Suite 170, Medford OR 97504-5589. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Providence Health & Services - Oregon can be contacted via phone (541) 732-6957, or through Jackson, John W via phone (541) 732-6000.

Contact Information

Primary practice address
1698 E Mcandrews Rd Suite 170 Medford OR 97504-5589
Fax: (541) 732-7901
Website:
Authorized official contact:
Name: Jackson, John W Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1558430314
LBN Legal business name Providence Health & Services - Oregon
DBA Doing business as Pmg South Diabetes Education
Authorized official Jackson, John W Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 7th, 2006
Last updated Dec 4th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558430314 NPPES
Oregon Other 500616621 DMAP
Oregon Other CG6801 DMAP

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